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Images in Nephrology
18 (
3
); 134-134
doi:
10.4103/0971-4065.43697

The veiled right kidney sign

Department of Radiology and Imaging, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh - 517 507, India
Department of General Surgery, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh - 517 507, India
Address for correspondence: Dr. A. Y. Lakshmi, Department of Radiology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, Andhra Pradesh - 517 507, India. E-mail: aylakshmi@yahoo.co.in
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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications and was migrated to Scientific Scholar after the change of Publisher.

The “veiled right kidney sign” is an uncommon entity in which the right kidney is masked by the collection of air around it in the retroperitoneum.12 A 20 year-old male presented with vomiting and distension of the abdomen following an accidental fall on a rock, sustaining a blunt injury over his abdomen. Hematological and routine blood biochemistry tests did not reveal any abnormalities. A plain skiagram of the abdomen (an anteroposterior (AP) view) showed the presence of air in the right perinephric region masking the right kidney. Contrast computed tomography of the abdomen revealed the presence of air in the right perinephric space and a moderate amount of fluid in the peritoneum [Fig. 1]. Laporotomy showed an injury in the third part of the duodenum. Closure of the duodenal laceration, gastrojejunostomy, and a decompression tube duodenostomy were performed after which the patient was discharged on recovery.

Fig. 1
Contrast-enhanced computed tomography axial section at the level of the lower pole of the kidneys showing evidence of foci of air in the mesentery and air collection around the right kidney

Traumatic blunt duodenal injury is associated with about 12% mortality. Morbidity and mortality from duodenal wounds may be reduced by early hospitalization, early diagnosis, and consequently, earlier surgical repair.3 The presence of air in the right perinephric region—“the veiled right kidney sign” —helps in this situation as an invaluable pointer towards appropriate management.12

Source of Support: Nil

Conflict of Interest: None declared.

References

  1. , , , . The “veiled right kidney sign”: An ultrasound finding in retroperitoneal perforation of duodenum. Br J Radiol. 1996;69:1061-3.
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  2. , . Veiled right kidney sign in a patient with Valentino's syndrome. N Engl J Med. 2006;354:e9.
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  3. , , . Traumatic injuries to the duodenum: A report of 98 patients. Ann Surg. 1975;181:92-8.
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